Note 6 - Intangible Assets (Details Textual) - USD ($) $ in Thousands	12 Months Ended
Dec. 31, 2019	Dec. 31, 2018
Amortization of Intangible Assets, Total	$ 4,402	$ 4,649
Physician and Customer Relationships [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period	7 years
Computer Software, Intangible Asset [Member]
Finite-Lived Intangible Assets, Remaining Amortization Period	1 year
Impairment of Intangible Assets, Finite-lived	$ 0	$ 0

The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets. As a noncash expense, this element is added back to net income when calculating cash provided by or used in operations using the indirect method.

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 230
-SubTopic 10
-Section 45
-Paragraph 28
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-URI http://asc.fasb.org/extlink&oid=118932676&loc=d3e3602-108585

Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 30
-Section 50
-Paragraph 2
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-URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 350
-SubTopic 30
-Section 45
-Paragraph 2
-URI http://asc.fasb.org/extlink&oid=6388964&loc=d3e16225-109274

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